Curative Effectiveness of DAA Approach Combined with Absorbable Screw Fixation through Auxiliary Small Incision in front of the Hip Joint for the Treatment of Pipkin TypeⅠand Ⅱ Femoral Head Fractures
Objective To investigate the clinical efficacy of direct anterior approach(DAA)combined with absorbable screw fixation through auxiliary small incision in front of the hip joint for the treatment of Pipkin type Ⅰand Ⅱ femoral head fractures.Methods The clinical data of 13 patients with Pipkin Ⅰ and Ⅱ type femoral head fractures admitted to our hospital from February 2017 to July 2022 were retrospectively analyzed.There were 7 males and 6 females,with an average age of 41.6 years(28-57 years).There were 8 cases of Pipkin type Ⅰ and 5 cases of Pipkin type Ⅱ.The patients underwent DAA approach combined with anterior hip joint assisted small incision absorbable screw fixation surgery.The operation time,intraoperative bleeding volume,and incidence of complications were recorded.The healing time of fractures was determined through postoperative X-ray and CT follow-up.At the last follow-up,hip joint function was evaluated using the visual analog scale(VAS)score,Harris score,and Thompson-Epstein score.Results The average surgical time for 13 patients was 103.7 min(86-116 min),with an average intraoperative bleeding of 96.3 mL(70-100 mL).The average follow-up time was 14.6 months(12-18 months).No complications such as femoral nerve,lateral femoral cutaneous nerve,or femoral vascular injury occurred,and there was no incision infection.At the last follow-up,the patients'VAS score and Harris score were(0.15±0.38)and(95.00±7.15)respectively,both of which showed significant improvement compared to preoperative scores[(5.38±1.19)and(17.00±4.78)](P<0.001).All patients had fractures that healed,with an average healing time of 3.6 months(3-8 months).At the last follow-up,there was no occurrence of femoral head necrosis or ectopic ossification,and one patient developed traumatic arthritis of the hip joint.The results of Thompson-Epstein evaluation at the last follow-up were excellent in 11 cases,good in 2 cases.Conclusion DAA approach combined with absorbable screw fixation through auxiliary small incision in front of the hip joint for the treatment of Pipkin type Ⅰ and Ⅱ femoral head fractures has small soft tissue damage,clear exposure of the fracture site,accurate fixation effect of absorbable screws through auxiliary small incision,and low incidence of complications.It can be used as an option for surgical treatment of Pipkin Ⅰ and Pipkin Ⅱ femoral head fractures.
Femoral head fracturesDAA approachAuxiliary small incision in front of the hip jointAbsorbable screwFixation
万方数据
维普
